Provider Demographics
NPI:1053440156
Name:JAVID, SHAHIN (DDS)
Entity Type:Individual
Prefix:
First Name:SHAHIN
Middle Name:
Last Name:JAVID
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27420 TOURNEY RD STE 230
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5635
Mailing Address - Country:US
Mailing Address - Phone:661-222-2242
Mailing Address - Fax:661-222-2236
Practice Address - Street 1:27420 TOURNEY RD STE 230A
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5635
Practice Address - Country:US
Practice Address - Phone:661-222-2242
Practice Address - Fax:661-222-2236
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABJ4608709122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist